BARİYATRİK CERRAHİ SONRASI KİLO KAYBI MİKTARI KARDİYOMETABOLİK RİSK AZALMASINI BELİRLEYEN BİR FAKTÖR MÜDÜR?

Öz

Amaç: Bu çalışma, bariyatrik cerrahi geçiren hastalarda farklı miktarda kilo kaybının kardiyometabolik sağlıktaki gelişmeleri uygun şekilde yansıtıp yansıtmadığını araştırmayı amaçlamıştır. Gereç ve Yöntem: Bariyatrik cerrahi (BC) geçiren ve altı ay takip edilen hastalar geriye dönük olarak kilo kayıplarına göre üç gruba ayrıldı (Grup-1:Düsük kilo kaybı; Grup-2:Orta kilo kaybı; Grup-3: Yüksek kilo kaybı). Cerrahi öncesinde ve sonrasında hastalar, bel çevresi, kan basıncı, glukoz, HDL-K ve trigliserid verileri kullanılarak hem metabolik sendrom (MetS) varlığı açısından değerlendirildi hem de literatürde mevcut bir hesaplayıcı kullanılarak, her hasta için kümelenmiş bir kardiyometabolik risk (KMR) skoru elde edildi. Her bir MetS kriteri ve KMR skorunun, operasyondan önce ve sonra gruplardaki değişimleri ve birbirleriyle ilişkileri karşılaştırıldı. Bulgular: Çalışmaya 66 hasta dahil edildi. Operasyon öncesi %74,2 olan MetS sıklığının operasyondan sonra %25,8’e düştüğü görüldü. Gruplar arasında kilo, bel çevresi, yağ kütlesi, açlık kan şekeri ve HOMA-IR değerlerindeki düşüşte anlamlı farklılık gözlendi. Ancak hem MetS parametrelerindeki hem de KMR skorundaki değişimde gruplar arası anlamlı bir farklılık bulunamadı. Kilo kaybı miktarıyla KMR skorundaki değişim arasında anlamlı negatif korelasyon saptanırken, ayrı ayrı MetS parametreleriyle kilo kaybı miktarı arasında herhangi bir ilişki gözlenmedi. Ayrıca kilo kaybındaki her %1’lik artışın, KMR skorunda %57’lik bir azalma ile ilişkili olduğu tespit edildi. Sonuç: Bariyatrik cerrahi sonrası kardiyometabolik risk parametrelerinde anlamlı azalma olmasına rağmen hastaların kilo kayıp miktarı, ayrı ayrı parametreleri etkilememektedir. Ancak hastaların kardiyometabolik küme risklerini değerlendirmek ve izleme için bir skorlama sistemi kullanmak, hastalarda ameliyat sonrasındaki kademeli değişiklikleri takip etmeyi mümkün kılacak, hekim ve beslenme uzmanlarının müdahalelerini daha hedefe yönelik ve verimli hale getirecektir.

Anahtar Kelimeler

• Metabolik sendrom
• bariyatrik cerrahi
• kardiyometabolik risk skoru
• kilo kaybı miktarı
• obezite

IS THE AMOUNT OF WEIGHT LOSS AFTER BARIATRIC SURGERY A FACTOR DETERMINING CARDIOMETABOLIC RISK REDUCTION?

Öz

Objective: This study aimed to investigate whether differential weight loss amount appropriately reflects improvements in cardiometabolic health in patients undergoing bariatric surgery. Materials and Methods: Patients who underwent bariatric surgery (BS) and were followed up for six months were divided into three groups according to their weight loss (Group-1: Low weight loss; Group-2: Moderate weight loss; Group-3: High weight loss). Before and after surgery, patients were evaluated for metabolic syndrome (MetS) using waist circumference, blood pressure, glucose, HDL-C, and triglyceride data, and a clustered cardiometabolic risk (CMR) score was obtained for each patient using a calculator available in the literature online. Changes in each MetS criterion and CMR score in the groups before and after the operation, and their relations with each other were compared. Results: Sixty-six patients were included in the study. It was observed that the prevalence of MetS, which was 74.2% before the operation, decreased to 25.8%. A significant difference was observed between the groups in the decrease in weight, waist circumference, fat mass, fasting blood sugar, and HOMA-IR values. However, no significant difference was found between the groups in the change in MetS parameters and CMR scores. While a significant negative correlation was found between the amount of weight loss and the difference in the CMR score, no relation was observed between each MetS parameter and the amount of weight loss. It was also found that each 1% increase in weight loss was associated with a 57% decrease in the CMR score. Conclusion: Although there is a significant decrease in cardiometabolic risk parameters after bariatric surgery, the amount of weight loss of the patients does not affect the individual parameters. However, using a scoring system to evaluate and monitor patients’ cardiometabolic cluster risks will make it possible to follow the gradual changes in patients after surgery, making interventions by physicians and nutritionists more targeted and efficient.

Anahtar Kelimeler

• Metabolic syndrome
• bariatric surgery
• cardiometabolic risk score
• amount of weight loss
• obesity

Kaynakça

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